Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.45 / $111.45 / $111.45	Facility		$111.45	$111.45	$111.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.57 / $111.45 / $111.45	Professional		$92.57	$111.45	$111.45
BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.37 / $588.49 / $1,071.83	Facility		$295.37	$588.49	$1,071.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.39 / $195.15 / $263.45	Professional		$185.39	$195.15	$263.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.79 / $126.85 / $127.50	Facility		$123.79	$126.85	$127.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $156.12 / $156.12 / $156.12	Professional		$156.12	$156.12	$156.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.22 / $112.22 / $112.22	Facility		$112.22	$112.22	$112.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.92 / $162.27 / $282.66	Professional		$81.92	$162.27	$282.66
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $111.45 / $141.03 / $141.03	Facility		$111.45	$141.03	$141.03
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $109.03 / $141.03 / $204.90	Professional		$109.03	$141.03	$204.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $118.41 / $144.41 / $166.07	Professional		$118.41	$144.41	$166.07
United Facility/Professional Professional Modifier Low / Median / High Price $68.09 / $91.64 / $137.94	Professional		$68.09	$91.64	$137.94